Anonymous preliminary risk assessment: process, benefits and limits

What a preliminary risk assessment is for

Before a private health or occupational disability insurance policy is taken out, the insurer asks health questions. People with pre-existing conditions often do not know in advance how they will be assessed. A rejection or a risk surcharge can affect later applications. With the anonymous preliminary risk assessment, the assessment can be clarified in advance.

How it works

• Your health information is carefully compiled together.
• An intermediary or service provider submits it to several insurers without your name and without your address. This is because the same condition can be assessed differently depending on the insurer.
• The insurers report back whether and how they would accept the risk.
• Possible outcomes are standard acceptance, risk surcharge, benefit exclusion or rejection.
• Only then do you decide whether, and with which insurer, you submit an application.

The Verbraucherzentrale consumer advice centre recommends an anonymous preliminary risk assessment, using occupational disability insurance as its example, if difficulties are to be expected because of pre-existing conditions.

In our experience, an insurer’s response may be binding regarding the assessment of a specific pre-existing condition included in the enquiry. This depends on the wording, the stated conditions and the information submitted. If an insurance application is submitted later, we include this response with it. The response alone does not guarantee acceptance of the application as a whole.

Why complete information matters

The following also applies to the preliminary assessment: the information must match what you later state in the application. Under § 19 VVG, you must disclose to the insurer the risk-relevant circumstances known to you that it asks about in text form (Textform). If this duty of disclosure (Anzeigepflicht) is breached, the insurer can, under certain conditions, withdraw from the contract, terminate it or adjust it. A favourable result based on incomplete information therefore does not help you.

Limits of the preliminary risk assessment

• The preliminary risk assessment does not replace an insurance application. The answer relates to the information submitted and the conditions stated in it.
• Not every insurer accepts anonymous enquiries. An experienced intermediary generally knows which ones do.
• Results can change if your health or your information changes.
• It does not replace advice on tariff and terms. Acceptance alone says nothing yet about whether the contract suits you.